Potential Of Tailoring Drugs To Genetic Makeup Confirmed, But Challenges Remain
- Date:
- November 19, 2001
- Source:
- University Of California - San Francisco
- Summary:
- At a time when harmful drug reactions are thought to rank just after strokes as a leading cause of death in the U.S., the potential benefits of tailoring drugs to a patient’s genetic makeup have been confirmed in a systematic study led by University of California, San Francisco scientists.
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At a time when harmful drug reactions are thought to rank just after strokes as a leading cause of death in the U.S., the potential benefits of tailoring drugs to a patient’s genetic makeup have been confirmed in a systematic study led by University of California, San Francisco scientists.
The quantitative assessment of the promise of this new approach – known as pharmacogenomics –confirms that many harmful drug reactions previously thought to be non-preventable may now actually be averted using genetic information about patients to select their drug therapies.
The study, the first systematic assessment of pharmacogenomics’ potential, is paired with an analysis of many remaining hurdles: questions about the effectiveness of the practice, inadequate training, funding and sites for carrying out patient genotyping; and the risk of creating inequities when developing drugs to avert problems caused by natural genetic differences linked to race.
The report appears in the November 14 issue of JAMA, the Journal of the American Medical Association.
The researchers first conducted two independent systematic literature reviews: one on studies reporting adverse drug reactions (ADRs) and one on studies reporting natural genetic variation, or variant alleles in genes for enzymes that metabolize drugs.
They then “linked” these two studies by focusing on the enzymes from the second search known to metabolize the drugs identified in the first search. This allowed them to assess the possible contribution of genetic variability to ADRs.
The results highlight a strong potential link between the genetic variants and adverse drug reactions. The scientists found that 59 percent of the drugs cited in the ADR study are metabolized by at least one enzyme with a naturally occurring variant known to cause poor metabolism.
Conversely, only 22 percent of randomly selected drugs sold in the U.S. and only 7 percent of randomly selected top-selling U.S. drugs are metabolized by enzymes with this genetic variability – differences greater than two-fold and eight-fold respectively.
“Our study confirms the powerful potential of genetic information to improve drug therapies, but it also emphasizes the importance of considering how genetics will affect both health care practice and the public,” said Kathryn A. Phillips, PhD, lead author on the report and UCSF associate professor of health economics and health services research in the UCSF School of Pharmacy and the Institute for Health Policy Studies.
“In the future,” the authors conclude, “we may all carry a ‘gene chip assay report’ that contains our unique genetic
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